Common blood thinner for pregnant women proven ineffective

It’s a daily injection to the belly for pregnant women at risk of developing blood clots and it’s ineffective, according to a clinical trial led by researchers at The Ottawa Hospital and published today by the medical journal The Lancet.As many as one in 10 pregnant women have a tendency to develop blood clots in their veins, a condition called thrombophilia. For two decades these women have often been prescribed the anticoagulant low molecular weight heparin (LMWH) to prevent pregnancy complications caused by placental blood clots. This treatment requires women to give themselves daily injections — a painful and demoralizing process that requires women to poke their abdomen with hundreds of needles over the course of their pregnancy.Now, a randomized clinical trial led by Dr. Marc Rodger, a senior scientist at the Ottawa Hospital Research Institute who heads up the Thrombosis Program of The Ottawa Hospital, provides conclusive evidence that the commonly prescribed LMWH anticoagulant has no positive benefits for the mother or child. In fact, Dr. Rodger’s study shows that LMWH treatments could actually cause pregnant women some minor harm by increasing bleeding, increasing their rates of induced labour and reducing their access to anesthesia during childbirth.”These results mean that many women around the world can save themselves a lot of unnecessary pain during pregnancy,” says Dr. Rodger, who is also a professor in the Faculty of Medicine at the University of Ottawa. “Using low molecular weight heparin unnecessarily medicalizes a woman’s pregnancy and is costly.”Since the 1990s, using LMWH to treat pregnant women with a tendency to develop blood clots became commonplace, despite the fact that a large, multi-site randomized clinical trial had never been conducted to prove its effectiveness. Low molecular weight heparin is also prescribed by many physicians worldwide to women, with and without thrombophilia, to prevent placenta blood clots that may lead to pregnancy loss, as well as preeclampsia (high blood pressure), placental abruption (heavy bleeding) and intra-uterine growth restrictions (low birth weight babies). The anticoagulant LMWH is also prescribed to prevent deep vein thrombosis (leg vein blood clots) and pulmonary embolisms (lung blood clots).”While I wish we could have shown that LMWH prevents complications, we actually proved it doesn’t help,” adds Dr. …

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Dr. Robert Cameron Chairs International Panel of Medical Specialists at 4th Annual Symposium on Lung-Sparing Therapies for Malignant Pleural…

Dr. Robert Cameron ThePacific Meso Center, in conjunction with The Office of Continuing Medical Education of the David Geffen School of Medicine at UCLA, held the 4th International Symposium on Lung-SparingTherapies for Malignant Pleural Mesothelioma on June 7, 2014 in Santa Monica, California. TheWorthington & Caron Law Firmwas proud to once again be a platinum sponsor of this unique medical seminar focusing on rational treatment options for patients with pleural mesothelioma.As in years past, the course organizer and chair of the symposium was thoracic surgeon and pleural mesothelioma specialist,Dr. Robert Cameron. An ardent supporter of rational lung-sparing treatments for pleural mesothelioma, and innovator of thepleurectomy/decortication(“PD”) surgical procedure, Dr. Cameron is the founder and director of both theComprehensive Mesothelioma Programat the UCLA Medical Center and…

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Protective mutations for type 2 diabetes pinpointed

An international team led by researchers at the Broad Institute and Massachusetts General Hospital (MGH) has identified mutations in a gene that can reduce the risk of developing type 2 diabetes, even in people who have risk factors such as obesity and old age. The results focus the search for developing novel therapeutic strategies for type 2 diabetes; if a drug can be developed that mimics the protective effect of these mutations, it could open up new ways of preventing this devastating disease.Type 2 diabetes affects over 300 million people worldwide and is rising rapidly in prevalence. Lifestyle changes and existing medicines slow the progression of the disease, but many patients are inadequately served by current treatments. The first step to developing a new therapy is discovering and validating a “drug target” — a human protein that, if activated or inhibited, results in prevention and treatment of the disease.The current study breaks new ground in type 2 diabetes research and guides future therapeutic development in this disease. In the new study, researchers describe the genetic analysis of 150,000 patients showing that rare mutations in a gene called SLC30A8 reduce risk of type 2 diabetes by 65 percent. The results were seen in patients from multiple ethnic groups, suggesting that a drug that mimics the effect of these mutations might have broad utility around the globe. The protein encoded by SLC30A8 had previously been shown to play an important role in the insulin-secreting beta cells of the pancreas, and a common variant in that gene was known to slightly influence the risk of type 2 diabetes. However, it was previously unclear whether inhibiting or activating the protein would be the best strategy for reducing disease risk — and how large an effect could be expected.”This work underscores that human genetics is not just a tool for understanding biology: it can also powerfully inform drug discovery by addressing one of the most challenging and important questions — knowing which targets to go after,” said co-senior author David Altshuler, deputy director and chief academic officer at the Broad Institute and a Harvard Medical School professor at Massachusetts General Hospital.The use of human genetics to identify protective mutations holds great potential. Mutations in a gene called CCR5 were found to protect against infection with HIV, the virus that causes AIDS; drugs have been developed that block the CCR5 protein. A similar protective association for heart disease set off a race to discover new cholesterol-lowering drugs when mutations in the gene PCSK9 were found to lower cholesterol levels and heart disease risk. …

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Acamprosate For Alcohol: Why the Research Might Be Wrong

Calcium may be curbing the urge to drink.“Occasionally,” reads the opening sentence of a commentary published online last month in Neuropsychopharmacology, “a paper comes along that fundamentally challenges what we thought we knew about a drug mechanism.” The drug in question is acamprosate, and the mechanism of action under scrutiny is the drug’s ability to promote abstinence in alcoholics. The author of the unusual commentary is Markus Heilig, Chief of the Laboratory of Clinical and Translational Studies at the National Institute on Alcohol Abuse and Alcoholism (NIAAA).Acamprosate, in use worldwide and currently the most widely prescribed medication for alcohol dependence in the U.S., may work by an entirely different mechanism than scientists have believed on the basis of hundreds of studies over …

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New research reinforces danger of drinking alcohol while pregnant

Women who drink alcohol at moderate or heavy levels in the early stages of their pregnancy might damage the growth and function of their placenta — the organ responsible for supplying everything that a developing infant needs until birth — research at The University of Manchester shows.Placentas studied in a laboratory environment showed that drinking alcohol at moderate (2/3 standard drinks) to high (4-6 standard drinks) rates reduced the cell growth in a woman’s placenta.The research, published in the journal PLoS One and funded by the British Medical Association, investigated the effect of alcohol and its major toxic breakdown product, acetaldehyde, had on the placenta in the first few weeks — a period essential for normal development where three primary germ cell layers in the very early infant develop into internal organs.While placental cell growth was reduced at mid and heavy drinking levels, the cells that ensure the placenta attaches to the mother were unaffected. Alcohol at very low concentrations (1-2units, equal to half or one standard drink) did not have any effect on growth or function. Scientists also found alcohol at moderate to heavy levels reduced the transport of an important amino acid — known as taurine — from mother to baby via the placenta.Taurine is vital for brain and physiological development. However, acetaldehyde did not have any effect on the transportation of taurine suggesting alcohol is the main culprit. Reduced taurine has been shown to have negative effects on behaviour and physical development, so this might explain why some neurological symptoms are seen in children of alcoholic mothers, the researchers conclude.Sylvia Lui, from the Tommy’s Maternal and Fetal Health Research Centre based at The University of Manchester who carried out the research, said: “Alcohol and acetaldehyde are known to be toxic at high levels, but these results clearly show that levels easily achieved in a normal population have specific effects in the placenta.”Placental growth is reduced in comparison to non-exposed placentas, suggesting that in the long-term, there could be consequences to how much support the infant receives from the placenta during the rest of the pregnancy after this exposure.”Dr Clare Tower, consultant obstetrician at Saint Mary’s Hospital part of Central Manchester University Hospitals NHS Foundation Trust, said: “Though low levels of alcohol did not have a harmful effect, moderate to high levels were damaging. The safest clinical advice would be to agree with the current Royal College of Obstetrics and Gynaecology guidelines and abstain.This is because UK studies show that there is still a lot of confusion in the perception of what alcohol ‘units’ are, as well as a lack of accurate self-monitoring of drinking levels.Professor John Aplin, Professor of Reproductive Biomedicine in the Tommy’s Maternal and Fetal Health Research Centre at the University, said “This research also suggests that women who are trying to conceive should not drink as the damage caused by alcohol can happen very early on in pregnancy — perhaps before a woman knows she is pregnant.”Jane Brewin, Chief Executive of baby charity Tommy’s, said: “It can often be a few weeks before a woman discovers she’s pregnant, and this research shows that moderate drinking during those vital first weeks can have a big impact on the development of the baby.”Many pregnancies are unplanned, but for those actively planning a family this research raises questions about whether women should consider their alcohol intake even before they fall pregnant.”Story Source:The above story is based on materials provided by Manchester University. Note: Materials may be edited for content and length.

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Optimizing donor kidney distribution in the United States

Northwestern University’s Sanjay Mehrotra has developed an innovative model that could help ease kidney distribution inequities among regions in the U.S. and ultimately help save hundreds of lives. His mathematical model, which takes into account a number of different factors, simulates and optimizes donor kidney distribution.Mehrotra will discuss his research in a presentation titled “Addressing Allocation Inefficiencies and Geographic Disparities” at the American Association for the Advancement of Science (AAAS) annual meeting in Chicago. His presentation is part of a symposium titled “Transplant Organ Shortage: Informing National Policies Using Management Sciences” to be held from 10 to 11:30 a.m. CST Friday, Feb. 14, in Columbus IJ of the Hyatt Regency Chicago.Mehrotra also will participate in a press briefing to be held at 1 p.m. CST the same day in Vevey Room 3 of the Swisstel Chicago.In addition to Mehrotra, two other Northwestern professors will discuss issues related to organ shortage during both the symposium and press briefing.Michael Abecassis, M.D., chief of the division of organ transplantation and founding director of the Comprehensive Transplant Center at Northwestern University Feinberg School of Medicine, will offer a brief overview of the current issues facing organ allocation.John Friedewald, M.D., associate professor in medicine and surgery at Feinberg and director of clinical research at Northwestern University Feinberg School of Medicine Comprehensive Transplant Center and transplant nephrologist at Northwestern Memorial Hospital, will speak about policy changes in kidney allocation that were developed during his recent term as chair of the United Network for Organ Sharing Kidney Transplantation Committee.Nearly 100,000 people in the United States are waiting for kidney transplants, but only 17,000 kidneys are available annually from both living and deceased donors. There are major regional inequalities in access to organs because of supply and demand disparities among different areas of the country. A person in one state might get a kidney within a year, while someone in another state might wait up to four years. As a consequence, nearly 5,000 people die each year waiting for a kidney transplant.Logistically, organ allocation is a difficult problem. …

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Arctic biodiversity under serious threat from climate change

Unique and irreplaceable Arctic wildlife and landscapes are crucially at risk due to global warming caused by human activities according to the Arctic Biodiversity Assessment (ABA), a new report prepared by 253 scientists from 15 countries under the auspices of the Conservation of Arctic Flora and Fauna (CAFF), the biodiversity working group of the Arctic Council.”An entire bio-climatic zone, the high Arctic, may disappear. Polar bears and the other highly adapted organisms cannot move further north, so they may go extinct. We risk losing several species forever,” says Hans Meltofte of Aarhus University, chief scientist of the report.From the iconic polar bear and elusive narwhal to the tiny Arctic flowers and lichens that paint the tundra in the summer months, the Arctic is home to a diversity of highly adapted animal, plant, fungal and microbial species. All told, there are more than 21,000 species.Maintaining biodiversity in the Arctic is important for many reasons. For Arctic peoples, biodiversity is a vital part of their material and spiritual existence. Arctic fisheries and tourism have global importance and represent immense economic value. Millions of Arctic birds and mammals that migrate and connect the Arctic to virtually all parts of the globe are also at risk from climate change in the Arctic as well as from development and hunting in temperate and tropical areas. Marine and terrestrial ecosystems such as vast areas of lowland tundra, wetlands, mountains, extensive shallow ocean shelves, millennia-old ice shelves and huge seabird cliffs are characteristic to the Arctic. These are now at stake, according to the report.”Climate change is by far the worst threat to Arctic biodiversity. Temperatures are expected to increase more in the Arctic compared to the global average, resulting in severe disruptions to Arctic biodiversity some of which are already visible,” warns Meltofte.A planetary increase of 2 C, the worldwide agreed upon acceptable limit of warming, is projected to result in vastly more heating in the Arctic with anticipated temperature increases of 2.8-7.8 C this century. …

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Madagascar sells first forest carbon credits to Microsoft

The Government of Madagascar has approved carbon sales with Microsoft and its carbon offset partner, The CarbonNeutral Company, and Zoo Zurich. The carbon credit sales will support the Government of Madagascar’s REDD+ Project (Reducing Emissions from Deforestation and Forest Degradation “plus” conservation) in the Makira Natural Park and mark the first sale of government-owned REDD+ credits in Africa.Through carbon credit sales from avoided deforestation, the Makira REDD+ Project will finance the long-term conservation of one of Madagascar’s most pristine remaining rainforest ecosystems harboring rare and threatened plants and animals while improving community land stewardship and supporting the livelihoods of the local people.Through a unique funding distribution mechanism designed by WCS and the Government of Madagascar, the funds from carbon sales will be used by the Government of Madagascar for conservation, capacity building, and enforcement activities, and by WCS to manage the Makira Natural Park. The largest share of the sale — half of the proceeds — will go to supporting local communities in the areas surrounding Makira for education, human health and other beneficial projects.”The Government of Madagascar is thrilled to have played the role of pioneer in carbon sales in Africa. Makira is a highly valued part of our natural heritage and the revenues from this sale will not only protect this oustanding area, but represent an important step in our plan to develop sustainable sources of financing for the whole protected area network. We hope that other organizations will follow the lead of Microsoft, The CarbonNeutral Company, and Zoo Zurich and join us in this effort to conserve Madagascar’s unique biodiversity through the sale of future carbon credits,” said Pierre Manganirina Randrianarisoa the Secretary General of the Ministry of Environment and Forests.Said WCS President and CEO Cristin Samper “These sales represent a first for WCS, a first for Africa, and a first for Madagascar in advancing the use of carbon credits to fight climate change while protecting biodiversity and human livelihoods. We are thankful to Microsoft, The CarbonNeutral Company and Zoo Zurich, and we look forward to future purchases by other forward-thinking organizations.”Said Rob Bernard, Chief Environmental Strategist at Microsoft: “Supporting forest conservation and community building projects like Makira is an important part of Microsoft’s strategy to reduce its environmental impact, support sustainable economic growth, improve health and education, and address societal challenges. The project’s important role in protecting a crucial area of biodiversity value also aligns with Microsoft’s own focus on using technology, information and research to develop new approaches and solutions to sustainability.”Said Jonathan Shopley, Managing Director of The CarbonNeutral Company: “Increasingly our clients are looking for opportunities to manage the entire environmental impact of their organisation, driven by the need to build resilience in their supply chains. The Makira project enables clients to do this by selling carbon credits while also delivering biodiversity value and community support.”Makira contains an estimated one percent of the world’s biodiversity including 20 lemur species, hundreds of species of birds, and thousands of plant varieties, including many found nowhere else on earth. The Makira forest spans nearly 400,000 hectares (more than 1,500 square miles), making it one of the largest remaining intact blocks of rainforest in Madagascar. In addition, Makira’s forests serve as a zone of watershed protection, providing clean water to over 250,000 people in the surrounding landscape.WCS, which has worked in Makira since 2003, is the delegated manager of the park and is responsible for implementing the REDD+ project that aims to safeguard the Makira Natural Park, one of Madagascar’s largest protected areas.Last September the Government of Madagascar and WCS announced that 710,588 carbon credits had been certified for sale from the Makira Forest REDD+ Project. …

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Pay for performance encouraged physicians to follow blood pressure guidelines

Sep. 10, 2013 — When health care pundits began to suggest that pay-for-performance would solve some of health care’s woes, Dr. Laura Petersen, professor of medicine at Baylor College of Medicine and director of the Houston VA Health Services Research and Development Center of Excellence, had questions.How do we know that it will solve those problems? she asked. How do we know whether or not it will create new problems? And how will we structure these payments? As a recognized expert in the area of health care services and quality, she set out to find the answers in a multi-year study involving 83 physicians and 42 other health care personnel in 12 different Veterans Affairs hospital-based outpatient clinics.She and her colleagues found that modest monetary incentives to individual physicians resulted in a significant 8.36 percent increase in patients whose blood pressure was brought down to desired levels or who received an appropriate medical response when it was found that their blood pressure was uncontrolled. However, incentives to a whole health care team or to the physician plus health care team did not have a significant effect. There was virtually no change at all in the control group that received no incentives. A report on their work appears in the Journal of the American Medical Association.”This is not a panacea for everything that is wrong in health care, but it can have a significant effect in improving care,” said Petersen, who is also associate chief of staff for research at the Michael E. …

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Genetic cause of childhood leukemia identified

Sep. 8, 2013 — For the first time, a genetic link specific to risk of childhood leukemia has been identified, according to a team of researchers from Memorial Sloan-Kettering Cancer Center, St. Jude Children’s Research Hospital, University of Washington, and other institutions. The discovery was reported online today in the journal Nature Genetics.”We’re in uncharted territory,” said study author Kenneth Offit, MD, MPH, Chief of the Clinical Genetics Service at Memorial Sloan-Kettering. “At the very least this discovery gives us a new window into inherited causes of childhood leukemia. More immediately, testing for this mutation may allow affected families to prevent leukemia in future generations.”The mutation was first observed in a family treated at Memorial Sloan-Kettering of which several family members of different generations had been diagnosed with childhood acute lymphoblastic leukemia (ALL). A second, non-related, leukemia-prone family cared for at a different hospital was later found to have the same mutation. A series of experiments were conducted confirming that the observed mutation compromised the normal function of the gene, which may increase the risk of developing ALL.The inherited genetic mutation is located in a gene called PAX5, which is known to play a role in the development of some B cell cancers, including ALL. PAX5, a transcription factor or “master gene,” regulates the activity of several other genes and is essential for maintaining the identity and function of B cells. In all study participants, one of the two copies of the PAX5 gene was missing, leaving only the mutated version. …

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Doubling the daily allowance of protein intake with diet and exercise protects muscle loss

Aug. 29, 2013 — A new report appearing in the September issue of The FASEB Journal challenges the long-held adage that significant muscle loss is unavoidable when losing weight through exercise and diet. In the report, scientists show that consuming twice the recommended daily allowance (RDA) of protein while adhering to a diet and exercise plan prevents the loss of muscle mass and promotes fat loss. Tripling the RDA of protein, however, failed to provide additional benefits.Share This:”It is our hope that the findings from this well-controlled study will be discussed and cited by the Institute of Medicine for the updated Dietary Reference Intakes on protein,” said Stefan M. Pasiakos, Ph.D., a researcher involved in the work from the Military Nutrition Division at the U.S. Army Research Institute of Environmental Medicine in Natick, MA. “We believe that the RDA for protein should be based on a level to optimize health, as well as prevent deficiencies, and our data demonstrate a potential inadequacy of the current RDA for sparing muscle mass during weight loss, which may affect a significant portion of the population.”To make this discovery, Pasiakos and colleagues assigned young men and women controlled diets for 31 days that provided dietary protein at three different levels: 1) the U.S. RDA, 2) twice the U.S. RDA, and 3) three times the U.S. RDA. …

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Now hear this: Scientists discover compound to prevent noise-related hearing loss

Aug. 29, 2013 — Your mother was right when she warned you that loud music could damage your hearing, but now scientists have discovered exactly what gets damaged and how. In a research report published in the September 2013 issue of The FASEB Journal, scientists describe exactly what type of damage noise does to the inner ear, and provide insights into a compound that may prevent noise-related damage.Share This:”Noise-induced hearing loss, with accompanying tinnitus and sound hypersensitivity is a common condition which leads to communication problems and social isolation,” said Xiaorui Shi, M.D., Ph.D., study author from the Department of Otolaryngology/Head and Neck Surgery at the Oregon Hearing Research Center at Oregon Health and Science University in Portland, Oregon. “The goal of our study is to understand the molecular mechanisms well enough to mitigate damage from exposure to loud sound.”To make this discovery, Shi and colleagues used three groups of 6 — 8 week old mice, which consisted of a control group, a group exposed to broadband noise at 120 decibels for three hours a day for two days, and a third group given single-dose injections of pigment epithelium-derived factor (PEDF) prior to noise exposure. PEDF is a protein found in vertebrates that is currently being researched for the treatment of diseases like heart disease and cancer. The cells that secrete PEDF in control animals showed a characteristic branched morphology, with the cells arranging in a self-avoidance pattern which provided good coverage of the capillary wall. The morphology of the same cells in the animals exposed to wide-band noise, however, showed clear differences — noise exposure caused changes in melanocytes located in the inner ear.”Hearing loss over time robs people of their quality of life,” said Gerald Weissmann, M.D., Editor-in-Chief of The FASEB Journal. “It’s easy to say that we should avoid loud noises, but in reality, this is not always possible. Front-line soldiers or first responders do not have time to worry about the long-term effects of loud noise when they are giving their all. If, however, a drug could be developed to minimize the negative effects of loud noises, it would benefit one and all.”Share this story on Facebook, Twitter, and Google:Other social bookmarking and sharing tools:|Story Source: The above story is based on materials provided by Federation of American Societies for Experimental Biology, via EurekAlert!, a service of AAAS. …

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Blocking molecular pathway reverses pulmonary hypertension in rats

Aug. 28, 2013 — Mark Nicolls and his colleagues discovered that blocking a pathway that causes inflammation could reverse a deadly condition known as pulmonary hypertension in rats.Pulmonary hypertension, a deadly form of high blood pressure that develops in the lungs, may be caused by an inflammation-producing molecular pathway that damages the inner lining of blood vessels, according to a new study by researchers at the Stanford University School of Medicine.The results, published Aug. 28 in Science Translational Medicine, suggest that using medications to block this pathway could lead to the first-known cure for the disease, apart from lung transplantation. The new research could also lead to a better understanding of other diseases involving inflammation of blood vessels, such as coronary artery disease, said Mark Nicolls, MD, senior author of the study and division chief of pulmonary and critical care medicine at Stanford, as well as a staff physician at the Veterans Affairs Palo Alto Health Care System.”We believe that targeting inflammation is an exciting approach to augment current treatments for pulmonary hypertension because it may reverse the underlying cause of the disease,” said Nicolls, who is also director of the Lung Immunology Program and an associate professor of medicine. “We believe this is going to be an approach that helps a large number of patients.”The lead author of the study is Wen Tian, PhD, a research associate in Nicolls’ lab.Pulmonary hypertension, while rare, usually strikes young and middle-aged women, leaving them short of breath and often unable to complete simple daily tasks. The condition can be fatal. The risk is higher for people with certain autoimmune diseases (such as scleroderma or lupus), HIV, congenital heart disease or liver disease. The risk also is higher for those who have used street drugs, such as amphetamines or cocaine, or the diet drug fenphen.About 100,000 people in the United States and Europe have been diagnosed with pulmonary hypertension, but many others are believed to go undiagnosed because the main symptom, shortness of breath, is nonspecific. Until the 1990s, there were no treatments except lung transplantation, which has varying degrees of success.What is known about the disease is that the narrowing of blood vessels in the lungs is caused by a mysterious proliferation of the smooth muscle cells that ring those vessels. As the vessel walls thicken, they become increasingly occluded, choking off blood flow.Blood vessels are elastic tubes that have an outer layer of smooth muscle and an inner layer of endothelial cells. …

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Blocking molecular pathway reverses pulmonary hypertension in rats

Aug. 28, 2013 — Mark Nicolls and his colleagues discovered that blocking a pathway that causes inflammation could reverse a deadly condition known as pulmonary hypertension in rats.Pulmonary hypertension, a deadly form of high blood pressure that develops in the lungs, may be caused by an inflammation-producing molecular pathway that damages the inner lining of blood vessels, according to a new study by researchers at the Stanford University School of Medicine.The results, published Aug. 28 in Science Translational Medicine, suggest that using medications to block this pathway could lead to the first-known cure for the disease, apart from lung transplantation. The new research could also lead to a better understanding of other diseases involving inflammation of blood vessels, such as coronary artery disease, said Mark Nicolls, MD, senior author of the study and division chief of pulmonary and critical care medicine at Stanford, as well as a staff physician at the Veterans Affairs Palo Alto Health Care System.”We believe that targeting inflammation is an exciting approach to augment current treatments for pulmonary hypertension because it may reverse the underlying cause of the disease,” said Nicolls, who is also director of the Lung Immunology Program and an associate professor of medicine. “We believe this is going to be an approach that helps a large number of patients.”The lead author of the study is Wen Tian, PhD, a research associate in Nicolls’ lab.Pulmonary hypertension, while rare, usually strikes young and middle-aged women, leaving them short of breath and often unable to complete simple daily tasks. The condition can be fatal. The risk is higher for people with certain autoimmune diseases (such as scleroderma or lupus), HIV, congenital heart disease or liver disease. The risk also is higher for those who have used street drugs, such as amphetamines or cocaine, or the diet drug fenphen.About 100,000 people in the United States and Europe have been diagnosed with pulmonary hypertension, but many others are believed to go undiagnosed because the main symptom, shortness of breath, is nonspecific. Until the 1990s, there were no treatments except lung transplantation, which has varying degrees of success.What is known about the disease is that the narrowing of blood vessels in the lungs is caused by a mysterious proliferation of the smooth muscle cells that ring those vessels. As the vessel walls thicken, they become increasingly occluded, choking off blood flow.Blood vessels are elastic tubes that have an outer layer of smooth muscle and an inner layer of endothelial cells. …

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New surgical tool may help sleep apnea sufferers

Aug. 27, 2013 — A Wayne State University researcher’s innovative use of a new tool may make surgery a more viable option for sufferers of obstructive sleep apnea/hypopnea syndrome (OSAHS).Ho-Sheng Lin, M.D., a fellow with the American College of Surgeons and professor of otolaryngology-head and neck surgery in the School of Medicine and Karmanos Cancer Institute, reported promising results in the July issue of The Laryngoscope, for treating sleep apnea using transoral robotic surgery (TORS), a technique whose safety and tolerability have recently been established for removing cancerous tumors in the back of the throat.Patients with OSAHS typically are treated with positive airway pressure (PAP), which is extremely safe and often effective. However, not all OSAHS patients can tolerate PAP, which involves wearing a mask during sleep that forces the airway open so they can continue breathing without interruption.For patients who cannot tolerate PAP, surgery may be a viable alternative. A common procedure, uvulopalatopharyngoplasty (UPPP), targets the obstruction at the level of the soft palate, but has only been found to be effective in less than 50 percent of cases.Lin, who also is chief of the otolaryngology section in the surgery department at the John D. Dingell VA Medical Center, said the less-than-optimal result from UPPP is not surprising. In patients with OSAHS, obstruction of air flow can occur at multiple levels of the throat; UPPP only addresses blockage at the soft palate level.”In order to be maximally effective, the surgeon must evaluate each patient individually to identify the exact site or sites of airway obstruction and then direct the surgical treatments to address those obstructions,” Lin said.Obstruction at the back of the tongue (BOT) can play a significant role in sleep apnea. Traditionally, surgical treatment of BOT blockage has been challenging because it’s hard for doctors to see and operate in that region.Using a robotic device called the da Vinci Surgical System, Lin can now gain improved access to the BOT region to safely and precisely remove the excessive tissue causing airway obstruction. In this study, he reported on the outcome of 12 patients — nine women and three men — who underwent BOT resection via TORS. They were selected for analysis because they underwent removal of excessive BOT tissue and nothing else.Two prior studies, one from Europe and another from the United States, also looked at treatment outcome following TORS-assisted BOT surgery in sleep apnea patients. However, in those studies, the BOT surgery was done in conjunction with other upper-airway surgeries, making it difficult to assess the effectiveness of the BOT procedure alone. …

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Neurologists report unique form of musical hallucinations

Aug. 20, 2013 — One night when she was trying to fall asleep, a 60-year-old woman suddenly began hearing music, as if a radio were playing at the back of her head.The songs were popular tunes her husband recognized when she sang or hummed them. But she herself could not identify them.This is the first known case of a patient hallucinating music that was familiar to people around her, but that she herself did not recognize, according to Dr. Danilo Vitorovic and Dr. José Biller of Loyola University Medical Center. The neurologists describe the unique case in the journal Frontiers in Neurology.The case raises “intriguing questions regarding memory, forgetting and access to lost memories,” the authors write.Musical hallucinations are a form of auditory hallucinations, in which patients hear songs, instrumental music or tunes, even though no such music is actually playing. Most patients realize they are hallucinating, and find the music intrusive and occasionally unpleasant. There is no cure.Musical hallucinations usually occur in older people. Several conditions are possible causes or predisposing factors, including hearing impairment, brain damage, epilepsy, intoxications and psychiatric disorders such as depression, schizophrenia and obsessive-compulsive disorder. Hearing impairment is the most common predisposing condition, but is not by itself sufficient to cause hallucinations.Vitorovic and Biller describe a hearing-impaired patient who initially hallucinated music when she was trying to fall asleep. …

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Answering critical questions to respond to anthrax attack

Aug. 15, 2013 — If terrorists targeted the United States with an anthrax attack, health care providers and policy makers would need key information — such as knowing the likelihood of an individual becoming infected, how many cases to expect and in what pattern, and how long to give antibiotics — to protect people from the deadly bacteria.Those questions gained urgency when anthrax-laced letters killed five people and infected 17 others in the wake of the terror attacks of September 2001. Now, using information from prior animal studies and data from a deadly anthrax exposure accident in Russia in the late 1970s, University of Utah and George E. Wahlen Department of Veterans Affairs Medical Center researchers have developed a mathematical model to help answer critical questions and guide the response to a large-scale anthrax exposure.In an Aug. 15, 2013, study in PLOS Pathogens online, the researchers use their model to estimate that for an individual to have a 50 percent chance of becoming infected with anthrax (known as ID50), he or she would have to inhale 11,000 spores of the bacteria. A 10 percent chance of being infected would require inhaling 1,700 spores and a 1 percent chance of infection would occur by inhaling 160 spores. The researchers also found that at ID50, the median time for anthrax symptoms to appear is 9.9 days and that the optimal time to take antibiotics is 60 days.”Anthrax is a well-studied disease and experimental animal data exist, but there is no real good information on dose response for the disease in humans,” says Adi V. Gundlapalli, M.D., Ph.D., an infectious diseases specialist and epidemiologist, associate professor of internal medicine at the U of U School of Medicine and staff physician at the Salt Lake City George E. Wahlen Department of Veterans Affairs Medical Center. “We don’t want to be overly fearful, but we need to be prepared in the event of a bioterrorism attack with anthrax.”Although studies with animals at other institutions have looked at anthrax, the data are limited and usually involved vaccine testing and not exposure amounts for infection. …

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Researchers use nanoparticles to fight cancer

Aug. 14, 2013 — Researchers at the University of Georgia are developing a new treatment technique that uses nanoparticles to reprogram immune cells so they are able to recognize and attack cancer.The findings were published recently in the early online edition of ACS Nano.The human body operates under a constant state of martial law. Chief among the enforcers charged with maintaining order is the immune system, a complex network that seeks out and destroys the hordes of invading bacteria and viruses that threaten the organic society as it goes about its work.The immune system is good at its job, but it’s not perfect. Most cancerous cells, for example, are able to avoid detection by the immune system because they so closely resemble normal cells, leaving the cancerous cells free to multiply and grow into life-threatening tumors while the body’s only protectors remain unaware.Shanta Dhar and her colleagues are giving the immune system a boost through their research.”What we are working on is specifically geared toward breast cancer,” said Dhar, the study’s co-author and an assistant professor of chemistry in the UGA Franklin College of Arts and Sciences. “Our paper reports for the first time that we can stimulate the immune system against breast cancer cells using mitochondria-targeted nanoparticles and light using a novel pathway.”In their experiments, Dhar and her colleagues exposed cancer cells in a petri dish to specially designed nanoparticles 1,000 times finer than the width of a human hair. The nanoparticles invade the cell and penetrate the mitochondria — the organelles responsible for producing the energy a cell needs to grow and replicate.They then activated the nanoparticles inside the cancer cells by exposing them to a tissue-penetrating long wavelength laser light. Once activated, the nanoparticles disrupt the cancer cell’s normal processes, eventually leading to its death.The dead cancer cells were collected and exposed to dendritic cells, one of the core components of the human immune system. What the researchers saw was remarkable.”We are able to potentially overcome some of the traditional drawbacks to today’s dendritic cell immunotherapy,” said Sean Marrache, a graduate student in Dhar’s lab. “By targeting nanoparticles to the mitochondria of cancer cells and exposing dendritic cells to these activated cancer cells, we found that the dendritic cells produced a high concentration of chemical signals that they normally don’t produce, and these signals have traditionally been integral to producing effective immune stimulation.”Dhar added that the “dendritic cells recognized the cancer as something foreign and began to produce high levels of interferon-gamma, which alerts the rest of the immune system to a foreign presence and signals it to attack. We basically used the cancer against itself.”She cautions that the results are preliminary, and the approach works only with certain forms of breast cancer. …

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Successful treatment of triple negative breast cancer by modulation of the OGF-OGFr axis

Aug. 10, 2013 — Researchers at The Pennsylvania State University College of Medicine, led by Dr. Ian S. Zagon, have discovered that a novel biological pathway, the OGF-OGFr axis, can be modulated in human triple-negative breast cancer cells to inhibit proliferation. According to BreastCancer.org 1 in 8 women in the U.S. will develop invasive breast cancer and more than 39,000 deaths occur annually. Approximately 15 to 20% of all breast cancers are designated as triple-negative meaning that the cancer cells lack estrogen and progesterone receptors, and do not overexpress human epidermal growth factor receptor (HER-2), thereby limiting responsiveness to approved therapy.Share This:In the June 2013 issue of Experimental Biology and Medicine, Zagon and colleagues demonstrate that exposure of human breast cancer cell lines to OGF in vitro repressed growth within 24 hr in a receptor-mediated and reversible manner. Treatment with low dosages of the opioid antagonist naltrexone (LDN) provoked a compensatory elevation in endogenous opioids (i.e., OGF) and receptors that interact for 18-20 hr daily following receptor blockade to elicit a robust inhibition of cell proliferation. Because OGF is an endogenous neuropeptide, there are minimal or no side effects. The mechanism of action for OGF is upregulation of the p21 cyclin-dependent inhibitory kinase pathway that delays passage through the cell cycle. …

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Ultrasound patch heals venous ulcers in human trial

Aug. 1, 2013 — In a small clinical study, researchers administered a new method for treating chronic wounds using a novel ultrasound applicator that can be worn like a band-aid. The applicator delivers low-frequency, low-intensity ultrasound directly to wounds, and was found to significantly accelerate healing in five patients with venous ulcers. Venous ulcers are caused when valves in the veins malfunction, causing blood to pool in the leg instead of returning to the heart. This pooling, called venous stasis, can cause proteins and cells in the vein to leak into the surrounding tissue leading to inflammation and formation of an ulcer.The technology was developed by researchers at Drexel University, Philadelphia, with funding from the National Institute of Biomedical Imaging and Bioengineering (NIBIB), part of the National Institutes of Health.Venous ulcers account for 80 percent of all chronic wounds found on lower extremities and affect approximately 500,000 U.S. patients annually, a number that’s expected to increase as obesity rates climb. It’s estimated that treatment for venous ulcers costs the U.S. healthcare system over $1 billion dollars per year.Standard treatment for venous ulcers involves controlling swelling, taking care of the wound by keeping it moist, preventing infection, and compression therapy — a technique in which patients wear elastic socks that squeeze the leg to prevent blood from flowing backwards. Despite these measures, wounds often take months and occasionally years to heal.”Right now, we rely mostly on passive treatments,” said Michael Weingarten, M.D., chief of vascular surgery at Drexel Medicine and a researcher in the study. “With the exception of expensive skin grafting surgeries, there are very few technologies that actively stimulate healing of these ulcers.”In an article to be published in the Journal of the Acoustical Society of America, the Drexel researchers report that patients who received low-frequency, low-intensity ultrasound treatment during their weekly check-up (in addition to standard compression therapy), showed a net reduction in wound size after just four weeks. …

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